Organization
LAKEWOOD IPA, INC
Active
Parent organization
LAKEWOOD IPA, INC
Other names
Fountain Valley IPA, Inc
Organization subpart
Yes
Provider details
NPI number
Legal business name
LAKEWOOD IPA, INC
Authorized official
MRS. VARSHA DESAI (CHIEF OPERATING OFFICER)
(562) 602-1563
Entity
Organization
Contact information
Practice address
4909 LAKEWOOD BLVD STE 200, LAKEWOOD, CA 90712-2405
(562) 602-1563
(562) 529-8490
Mailing address
4909 LAKEWOOD BLVD STE 200, LAKEWOOD, CA 90712-2405
(562) 602-1563
(562) 529-8490
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
—
—
Other
Enumeration date
07/10/2015
Last updated
07/10/2015
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